Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. Financial Criteria


  • Two groups are financially eligible for nursing home services:

    • Group A includes individuals who are eligible because they are receiving SSI.

    • Group B includes persons with incomes up to the special income standard of 300 percent of SSI, which is $1,656.

  • Asset limits for both groups are $2,000 for an individual and $3,000 for a couple.

  • The monthly personal needs allowance is $60 for individuals and $120 for couples.2

  • Because Texas does not have a medically needy program, in accordance with federal law, categorically eligible individuals in need of nursing home care--whose income exceeds the special income standard but is insufficient to cover the cost of care--may place income in excess of the special income level in a Qualified Income Trust, known as a Miller Trust. Once the trust is operative, they receive Medicaid coverage for both nursing home care and other Medicaid state plan services.

2. When SSI recipients enter a nursing home, SSI provides only $30 for personal needs. For these individuals, the state provides a supplement of $30 per month.

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